Indicator for tool state and communication in multi-arm robotic telesurgery

ABSTRACT

A surgical manipulator assembly comprises a manipulator movably supporting a tool holder and an indicator section operably coupled to the manipulator for indicating state or identity information. The indicator section includes a multiple-color light emitting diode (LED) and a first fastener for operably coupling a second fastener of a sterile drape used to substantially cover the surgical manipulator assembly.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Application No.60/752,755, filed Dec. 20, 2005, the full disclosure of which (includingall references incorporated by reference therein) is incorporated byreference herein for all purposes.

This application is also a continuation-in-part of U.S. patentapplication Ser. No. 11/478,416, filed Jun. 20, 2006, the fulldisclosure of which (including all references incorporated by referencetherein) is incorporated by reference herein for all purposes.

TECHNICAL FIELD

The present invention is generally related to medical and/or roboticdevices, systems, and methods.

BACKGROUND

Minimally invasive medical techniques are intended to reduce the amountof extraneous tissue which is damaged during diagnostic or surgicalprocedures, thereby reducing patient recovery time, discomfort, anddeleterious side effects. One effect of minimally invasive surgery, forexample, may be reduced post-operative hospital recovery times. Becausethe average hospital stay for a standard surgery is typicallysignificantly longer than the average stay for an analogous minimallyinvasive surgery, increased use of minimally invasive techniques couldsave millions of dollars in hospital costs each year. While many of thesurgeries performed each year in the United States could potentially beperformed in a minimally invasive manner, only a portion of the currentsurgeries use these advantageous techniques due to limitations inminimally invasive surgical instruments and the additional surgicaltraining involved in mastering them.

Minimally invasive robotic surgical or telesurgical systems have beendeveloped to increase a surgeon's dexterity and to avoid some of thelimitations on traditional minimally invasive techniques. Intelesurgery, the surgeon uses some form of remote control, e.g., aservomechanism or the like, to manipulate surgical instrument movements,rather than directly holding and moving the instruments by hand. Intelesurgery systems, the surgeon can be provided with an image of thesurgical site at the surgical workstation. While viewing a two or threedimensional image of the surgical site on a display, the surgeonperforms the surgical procedures on the patient by manipulating mastercontrol devices, which in turn control motion of the servomechanicallyoperated instruments.

The servomechanism used for telesurgery will often accept input from twomaster controllers (one for each of the surgeon's hands) and may includetwo or more robotic arms or manipulators on each of which a surgicalinstrument is mounted. Operative communication between mastercontrollers and associated robotic arm and instrument assemblies istypically achieved through a control system. The control systemtypically includes at least one processor which relays input commandsfrom the master controllers to the associated robotic arm and instrumentassemblies and back from the instrument and arm assemblies to theassociated master controllers in the case of, e.g., force feedback orthe like. One example of a robotic surgical system is the DA VINCI®system available from Intuitive Surgical, Inc. of Sunnyvale, Calif.

The roles and interaction among the persons making up a telesurgicalteam may differ from those of conventional surgery. As telesurgery isoften performed in an internal surgical site, at least some of thoseworking under the direction of the lead surgeon (or other robotic systemoperator) may not have direct access to or direct visualization of theongoing tissue manipulations. For example, surgical assistants withinthe operating room may remove a first surgical instrument (such as anelectrosurgical scalpel) from a manipulator and replace it with adifferent surgical instrument (such as a needle holder), as a surgeonmay desire the use of different surgical instruments during differentphases of a surgical procedure. Similarly, the assistant may repositiona surgical instrument during a procedure, so that rather thanapproaching the procedure from a first minimally invasive access site,the instrument is advanced toward the internal surgical site from asecond, different access site. More complex robotic systems (and teaminteractions) may also be used. For example, as surgery is oftenperformed with more than two tools, input devices may be provided forone or more additional surgeons, with each additional surgeonrobotically controlling (for example) at least one surgical instrument.

While the new telesurgical systems, devices and methods have provenhighly effective and advantageous, still further improvements would bedesirable. In general, it would be desirable to provide improved roboticand/or surgical devices, systems and methods, particularly forperforming telesurgical procedures. It may also be desirable to provideimproved techniques for communication among the members of atelesurgical team, and for interfacing with the telesurgical apparatusso as to more fully take advantage of the capabilities of telesurgery toprovide enhanced patient outcomes with improved efficiencies. It may beparticularly beneficial to avoid unnecessary interruptions anddistractions of a surgeon or other system operator, and to avoid delaysand/or mistakes in the coordinated activities of a telesurgical team.

SUMMARY

The present invention provides a surgical manipulator assembly andsystem including an indicator component for providing signals, such asstate or identity information. In one embodiment, the invention providesan indicator associated with one or more robotic manipulator assembliesfor communication of a state of the manipulator assembly or othercomponent of the robotic system, for identification of one or moreparticular manipulators, or the like. The indicator(s) can provide anadditional user interface between the robotic system and, for example, asurgical assistant, system operator, or the like.

In accordance with an embodiment of the present invention, a surgicalmanipulator assembly is provided, the assembly comprising a manipulatormovably supporting a tool holder; and an indicator section operablycoupled to the manipulator for indicating state or identity information,the indicator section including a multiple-color light emitting diode(LED) and a translucent housing.

In accordance with an embodiment of the present invention, anothersurgical manipulator assembly is provided, the assembly comprising amanipulator movably supporting a tool holder for mounting a tool; and anindicator section operably coupled to the manipulator for indicatingstate or identity information, the indicator section including amultiple-color light emitting diode (LED), a translucent housing, and amagnet for operably coupling to a metal tab of a sterile drape used tosubstantially cover the surgical manipulator assembly from a sterilefield.

In accordance with yet another embodiment of the present invention, arobotic surgical manipulator system is provided, the system comprising amanipulator assembly, including a manipulator movably supporting a toolholder, and an indicator section operably coupled to the manipulator forindicating state or identity information, the indicator sectionincluding a multiple-color light emitting diode (LED) and a translucenthousing. The system further includes a tool mounted on the tool holder,and a processor operably coupled to the manipulator assembly forinducing the LED to indicate state or identity information.

Advantageously, the present invention provides for facilitatingcommunications between the telesurgical system and/or members of atelesurgical team.

The scope of the invention is defined by the claims, which areincorporated into this section by reference. A more completeunderstanding of embodiments of the present invention will be affordedto those skilled in the art, as well as a realization of additionaladvantages thereof, by a consideration of the following detaileddescription of one or more embodiments. Reference will be made to theappended sheets of drawings that will first be described briefly.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic plan view of a portion of an operating theaterillustrating a robotic surgical system in use, including a mastersurgeon console or workstation for inputting a surgical procedure and arobotic manipulator system for robotically moving surgical instrumentshaving surgical end effectors at a surgical site within a patient.

FIG. 2 is a perspective view of an embodiment of a manipulator system,including positioning linkages or set up joints which allow at least twopatient side robotic manipulators and one endoscope or camera roboticmanipulator to be pre-configured for surgery.

FIG. 3 is a perspective view of an example of an articulated surgicalinstrument for use in the system of FIG. 1.

FIG. 4 is a perspective from above of an alternative manipulator systemincluding a plurality of positioning linkages, each supporting amanipulator assembly.

FIG. 5 is a perspective view of a manipulator for use in a manipulatorsystem in accordance with an embodiment of the present invention.

FIG. 6 is a detailed view of an interface portion of the manipulator ofFIG. 5, showing a tool holder and adjacent indicator section foroutputting visual signals.

FIGS. 7A and 7B show a front view and a side view, respectively, of thetool holder portion including the indicator and radiation patterns.

FIGS. 8A and 8B show perspective views of the indicator section inisolation in accordance with an embodiment of the present invention.

FIGS. 9A and 9B illustrate a surface texture of the indicator section inaccordance with an embodiment of the present invention.

FIG. 10 illustrates the indicator section including a magnet foroperably coupling to a metal tab in accordance with an embodiment of thepresent invention.

FIG. 11 is a schematic block diagram of an embodiment of an alternativerobotic system and method for its use by a plurality of systemoperators.

FIG. 12 is a flow chart schematically describing a method forreconfiguring a manipulator assembly in response to an identifiablesignal from an associated indicator.

FIG. 13 is a listing of separately identifiable visual signals which maybe generated by the indicator of FIG. 6, along with their associatedmeanings, in accordance with an embodiment of the present invention.

FIG. 14 illustrates colors which can be generated by the indicator ofFIG. 6, along with the general meanings of those colors, in accordancewith an embodiment of the present invention.

Embodiments of the present invention and their advantages are bestunderstood by referring to the detailed description that follows. Itshould be appreciated that like reference numerals are used to identifylike elements illustrated in one or more of the figures. It should alsobe appreciated that the figures may not be necessarily drawn to scale.

DETAILED DESCRIPTION

The present invention generally provides improved robotic and/or medicaldevices, systems and methods. Embodiments of the present invention areparticularly well suited for telesurgery, often providing an additionalform of user interface that can enhance communication between a surgicalsystem operator, an assistant, other members of a telesurgical team,and/or the telesurgical system. Other embodiments of the invention maybe well suited for use in other telerobotic or robotic environments,particularly with robotic systems having a plurality of manipulators.

FIGS. 1-3 illustrate components of a robotic surgical system 1 forperforming minimally invasive robotic surgery. System 1 is similar tothat described in more detail in U.S. Pat. No. 6,246,200, the fulldisclosure of which is incorporated herein by reference. A systemoperator O (generally a surgeon) performs a minimally invasive surgicalprocedure on a patient P lying on an operating table T. The systemoperator O manipulates one or more input devices or masters 2 at asurgeon's console 3. In response to the surgeon's input commands, acomputer processor 4 of console 3 directs movement of endoscopicsurgical instruments or tools 5, effecting servomechanical movement ofthe instruments via a robotic patient-side manipulator system 6 (acart-mounted system in this example).

Typically, manipulator system 6 includes at least 3 robotic manipulatorassemblies. Two linkages 7 (mounted at the sides of the cart in thisexample) support and position manipulators 8 with linkages 7 in generalsupporting a base of the manipulators 8 at a fixed location during atleast a portion of the surgical procedure. Manipulators 8 move surgicaltools 5 for robotic manipulation of tissues. One additional linkage 9(mounted at the center of the cart in this example) supports andpositions manipulator 10 which controls the motion of anendoscope/camera probe 11 to capture an image (preferably stereoscopic)of the internal surgical site. The fixable portion of positioninglinkages 7, 9 of the patient-side system is sometimes referred to hereinas a “set-up arm”.

In one example, the image of the internal surgical site is shown tooperator O by a stereoscopic display 12 in surgeon's console 3. Theinternal surgical site is simultaneously shown to assistant A by anassistance display 14. Assistant A assists in pre-positioningmanipulator assemblies 8 and 10 relative to patient P using set-uplinkage arms 7, 9; in swapping tools 5 from one or more of the surgicalmanipulators for alternative surgical tools or instruments 5′; inoperating related non-robotic medical instruments and equipment; inmanually moving a manipulator assembly so that the associated toolaccesses the internal surgical site through a different aperture, andthe like.

In general terms, the linkages 7, 9 are used primarily during set-up ofpatient-side system 6, and typically remain in a fixed configurationduring at least a portion of a surgical procedure. Manipulators 8, 10each comprise a driven linkage which is actively articulated under thedirection of surgeon's console 3. Although one or more of the joints ofthe set-up arm may optionally be driven and robotically controlled, atleast some of the set-up arm joints may be configured for manualpositioning by assistant A.

For convenience, a manipulator such as manipulator 8 that is supportinga surgical tool used to manipulate tissues is sometimes referred to as apatient-side manipulator (PSM), while a manipulator 10 which controls animage capture or data acquisition device such as endoscope 11 may bereferred to as an endoscope-camera manipulator (ECM). The manipulatorsmay optionally actuate, maneuver and control a wide variety ofinstruments, tools, image capture devices, and the like which are usefulfor surgery.

As can be seen in FIGS. 1 and 2, indicators 20 are disposed on eachmanipulator assembly. In this embodiment, indicators 20 are disposed onmanipulators 8, 10 near the interface between the manipulators and theirmounted tools 5. In alternative embodiments, indicators 20 may insteadbe disposed on set-up joints 7, 9, on tools 5, elsewhere on manipulators8, 10, or the like, with the indicators preferably being sufficientlyclose to the tools so that a signal generated by a particular indicatorcan be readily associated with a particular tool when the signal isviewed by assistant A. In FIG. 1, additional indicators 20 are shown ina rack or other structure supporting additional tools 5′, with eachindicator again being associated with a particular tool (or type oftool).

As can be seen in FIG. 1, the system operator O is largely immersed inthe environment of and interaction with workstation 3. The systemoperator sees images presented by display 12 and manipulates inputdevices 2, and in this embodiment, processor 4 correlates the movementof the end effectors of tools 5 so that the images of the end effectorsfollow the movements of the input devices in the hands of the systemoperator O.

It can be advantageous to avoid distracting system operator O during asurgical procedure which may shift the operator's attention away fromthe internal surgical site. Even when assistant A is replacing a tool 5with an alternative tool 5′, the system operator may continuemanipulating tissues with another tool, or may want to continue to viewthe surgical site to monitor bleeding, and/or the like. Nonetheless, itmay be difficult for the system operator to communicate clearly withassistant A regarding which tool 5 is to be replaced by an alternatetool. Specifically, as endoscope 11 may be at any convenientorientation, the tool associated with the right hand of system operatorO will often not be disposed to the right of the endoscope, particularlyas viewed by the assistant.

So as to unambiguously identify a tool 5 to be replaced by assistant A,system operator O may input a command into workstation 3 (such as bypushing a button on the input device 2, actuating a foot peddle,inputting a voice command, or the like) so that indicator 20 on themanipulator assembly associated with the specific tool 5 generates avisually identifiable signal that can be viewed by the assistant. Acorresponding graphical indication of the signal may be provided tosystem operator O in display 12, such as presentation of an appropriateicon, superimposing of text on the surgical site, the use of imageprocessing to superimpose false colors on the image of the appropriateend effector, or the like. In response to the signal on indicator 20,assistant A can remove and replace the identified tool 5.

There are a number at additional uses for indicators 20 in telesurgicalsystem 1. For example, assistant A will often manually position tools 5and endoscope 11 when setting up for a surgical procedure, whenreconfiguring the manipulator system 6 for a different phase of asurgical procedure, when removing and replacing a tool with an alternatetool 5′, and the like. During such manual reconfiguring of themanipulator assembly by assistant A, the manipulator assembly may beplaced in a different mode than is used during master/slave telesurgery,with the manually repositionable mode sometimes being referred to as aclutch mode. The manipulator assembly may change between the tissuemanipulation mode and the clutch mode in response to an input such aspushing a button or switch on manipulator 8 (or some other component tothe manipulator assembly) (e.g., clutch button/switch 91 in FIGS. 6-8)thereby allowing assistant A to change the manipulator mode. Bygenerating appropriate visually identifiable signals with indicators 20whenever the manipulator is in the clutch mode, assistant A can avoiderrors and increase the efficiency of the surgical procedure.

Indicators 20 may also show an associated identifiable signal when, forexample, no tool is attached to the manipulator, when a sterile adaptoror interface between tool 5 and manipulator 8 is not properly attached,if an instrument mounted onto a manipulator is incompatible with thatmanipulator, if the instrument has reached the end of its useful life,and/or the like. For some of these signals, system operator O mayinitiate generation of the signal and may specify the associatedmanipulator assembly from which the signal is to be produced. In others,processor 4 may initiate the signal and/or indicate which manipulatorassembly is to be indicated. For example, in the case of a powerfailure, robotic system 1 may continue to operate using backupbatteries. So as to indicate to the assistant A that a power failure hasoccurred, indicators 20 on all manipulators may blink, optionallyblinking with a yellow light as a warning. As the power in the batteryis drained so that robotic system 1 can no longer continue to providerobotic movement of the tools, all indicators 20 may blink red, therebyindicating a system fault. A wide variety of alternative signals mayalso be provided, some of which are indicated by the lexicography ofFIG. 13.

FIG. 3 illustrates a perspective view of an articulated surgical tool orinstrument 5. Tool 5 has a proximal housing 24 which interfaces with atool holder of the manipulator, generally providing a quick releasemounting engagement through a sterile adapter or interface, an exampleof which is disclosed in U.S. patent application Ser. No. 11/314,040,filed Dec. 20, 2005, and U.S. patent application Ser. No. 11/395,418,filed Mar. 31, 2006, which are incorporated by reference herein for allpurposes. Tool 5 includes an elongate shaft 23 supporting an endeffector 28 relative to proximal housing 24. Proximal housing 24 acceptsand transmits drive signals or drive motion between the manipulator 8and the end effector 28. An articulated wrist 29 may provide two degreesof freedom of motion between end effector 28 and shaft 23, and the shaftmay be rotatable relative to proximal housing 24 about the axis of theshaft so as to provide the end effector 28 with three orientationaldegrees of freedom within the patient's body.

Referring now to FIG. 4, a perspective view is illustrated of analternative modular manipulator support assembly 30 that may be mountedto a ceiling of an operating room. The modular manipulator support 30aligns and supports a robotic manipulator system relative to a set ofdesired surgical incision sites in a patient's body. Modular manipulatorsupport 30 generally includes an orientating platform 36 and a pluralityof configurable set-up linkage arms 38, 40, 42, 44 that may be coupledto the orienting platform. Each arm movably supports an associatedmanipulator 32, 34, which in turn movably supports an associated tool oran image capture device. Orienting platform 36 also supports anassistant display 104, which may be used for set-up, instrument changes,viewing of the procedure and the like. The structures and use of any ofthe components of modular manipulator support assembly 30 are analogousto those described above regarding manipulator system 6, and are morefully described in co-pending U.S. patent application Ser. No.11/043,698, filed on Jan.24, 2005, and entitled “Modulator ManipulatorSupport For Robotic Surgery”, the full disclosure of which isincorporated herein by reference. As generally described above, eachmanipulator 32, 34 of modular manipulator support 30 may include anindicator 20.

Manipulator 8, 10 is shown in more detail in FIG. 5, which also showsindicator 20 near a tool holder 52. The indicator 20 is shown in moredetail in FIG. 6, and in isolation (with some of the internal componentsbeing schematically shown by dashed lines) in FIGS. 7A-7B and 8A-8B. Inone embodiment, the indicator 20 generally comprises a clear and/ortranslucent polymer body or housing 54 in which a light emitting diode(LED) array 56 is mounted. In this embodiment, a pair of LED arrays 56are included LED array 56 includes a red LED, a blue LED, and a yellowLED in one example. In another example, LED array 56 includes a red LED,a green LED, and a blue LED. The LEDs of each array can be independentlyenergized to any of a plurality of illumination or brightness levels,allowing indicator 20 to generate signals in a wide variety of colors,as schematically illustrated in FIG. 14. Additionally, the overall levelof illumination from indicator 20 may be varied, and a pattern may beimposed on the cover signal by blinking the illumination on and off,alternating between two different colors, alternating between twodifferent illumination levels, simultaneously displaying two differentcolors, or the like. The speed of blinking may also be controlled oraltered in more complex modulation patterns (with long and short blinks,Morse code, and the like).

As different colors may be combined with different illumination levelsand different modulation patterns in a signal, a very large number ofindependently identifiable signals can be generated, often being morethan three separately identifiable signals, typically being more than 10separately identifiable signals, and optionally being more than 100separately identifiable signals. Interpretation of the identifiablesignals may be facilitated by a list correlating signals and theirmeaning, such as that included as FIG. 13 in one example. In someembodiments, a relatively simple signal scheme with a more limitednumber of signals output by indicator 20 may be combined withsupplemental text or graphics output from the assistant display 104 orthe like. Hence, the assistant may know that they should look foradditional information on the assistant display in response to one ormore signals.

So as to facilitate interpretation of the signals generated byindicators 20, a wide variety of signal conventions may be establishedand/or employed. For example, as can be understood with reference toFIG. 14, signals including the color yellow may generally indicate awarning. Optionally, the manipulator assembly may continue to functionwhile its indicator 20 displays such a yellow warning signal, but theassistant may understand that some action may be advisable. The specificaction or meaning of the warning signal may depend on other aspects ofthe signal, such as other colors being interspersed with a blinkingyellow illumination pattern, speed of blinking, or the like. Signalsincluding red may indicate a current or imminent fault that is now ormay soon interfere with operation of the manipulator assembly. Green mayoptionally indicate normal operation is underway, blue may indicate aninstrument or a tool is engaged, and/or that a guided tool change isunderway or has been requested. Purple may indicate that a secondsurgeon or system operator is actively controlling the manipulatorassembly, or the like. Slow blinking lights may generally indicate aless urgent state than a rapidly blinking indicator 20. Some of thesepossible conventions are graphically illustrated in FIG. 14.

Referring to FIGS. 7A and 7B, a front view and a side view,respectively, of a tool holder portion and indicator section 20 areshown, including examples of radiation patterns emanating from LEDarrays 56, shown by lines R. In one example, the 2θ1/2 angle for LEDarrays 56 is about 120 degrees. The 2θ1/2 angle is the full viewingangle where the luminous intensity of the LEDs is ½ the intensity of thedirect on view. Lines R do not account for the internal reflection inthe housing 54, diffusion after internal reflection, and the additionalradiation beyond the 2θ1/2 angle boundary. Also illustrated are sidegrip points 99 a and front/back grip points 99 b for the user to gripand/or manually move the manipulator while operating clutchbutton/switch 91.

Referring to FIGS. 8A and 88, indicator section 20 includes clutchbutton/switch 91, mounting holes 92, a circuit board 93 to which the LEDarrays 56 are mounted, an electrical connector 94 (e.g., a flat flexiblecable connector), and mounting screws 95 to mount the circuit board 93to the housing 54.

FIGS. 9A and 9B illustrate front and back perspective views ofbody/housing 54. In one embodiment, housing 54 is comprised ofpolycarbonate or similar clear plastic with an acceptable or compliantUL flame rating. In yet another embodiment, the exterior surface ofhousing 54 is relatively rough or frosted, thereby providing forincreased dispersion of light, and the interior surface of housing 54 isrelatively smooth or polished, thereby allowing for better transmittanceof the dispersed light. The hashed lines in FIGS. 9A and 9B illustratethe frosted exterior surface of housing 54.

FIG. 10 illustrates an optional magnet 97 included in indicator section20 and a metal strip 98 that is part of a sterile drape (not shown) usedto aid in substantially covering the manipulator, assembly, and systemof the present invention to maintain a sterile field. An example of asterile drape is disclosed in U.S. application Ser. No. 11/240,113,filed Sep. 30, 2005, the full disclosure of which is incorporated hereinby reference. Magnet 97 operably couples to metal strip 98 tocontrollably hold the drape portion to the indicator section and themanipulator, thereby allowing for management of drape material (inparticular for keeping excess drape material from obstructing instrumentengagements). In one example, magnet 97 may be press fit and/or gluedonto the indicator section. Alternatively, metal strip 96 and magnet 97may be switched such that a magnet, as a part of the sterile drape, anda metal portion, as a part of the indicator section, may be operablycoupled to aid in substantially covering the manipulator, assembly, andsystem of the present invention to maintain a sterile field.

Referring now to FIG. 11, a schematic block diagram of a somewhat morecomplex system 60 is provided. Cooperative telesurgical systems whichmay be modified to take advantage of the additional user interfaceprovided by indicators 20 is described in more detail in U.S. Pat. No.6,659,939, the full disclosure of which is incorporated herein byreference. In the system of FIG. 11, a first system operator O1 providesinput to a first input device 2. Processor 4 selectively couples themovement commands from the first input device 2 to any of a plurality ofmanipulator assemblies, for example, to manipulator A and manipulator D.A second system operator O2 inputs movement commands to a second inputdevice 2 so as to effect movement of a manipulator 8 manipulatorassembly B.

When the second system operator O2 desires the tool 5 attached tomanipulator assembly B be replaced by an alternate tool 5′, for example,tool F, the system operator may verbally instruct assistant A to mounttool F to his manipulator assembly. The indicator 20 of manipulatorassembly B generates a signal in response to an appropriate input by thesecond system operator O2, clearly indicating to the assistant A whichtool from which manipulator assembly is to be replaced. As noted above,additional indicators may optionally be associated with each of thealternative tools 5′, thereby foregoing any need for verbal instructionto the assistant regarding which alternative tool is to be mounted tothe manipulator.

Processor 4 wilt typically include data processing hardware andsoftware, with the software typically comprising machine-readable code.The machine-readable code will embody software programming instructionsto implement some or all of the methods described herein. Whileprocessor 4 is shown as a single block in the simplified schematic ofFIG. 11, the processor may comprise a number of data processingcircuits, with at least a portion of the processing optionally beingperformed adjacent input device 1, a portion being performed adjacentmanipulator B, and the like. Any of a wide variety of centralized ordistributed data processing architectures may be employed. Similarly,the programming code may be implemented as a number of separate programsor subroutines, or may be integrated into a number of other aspects ofthe robotic systems described herein.

Referring now to FIG. 12, a flowchart 70 schematically illustrates amethod for implementing an embodiment of the present invention. Themethod 70 may begin with a change in state of the manipulator, tool,system, or the like at a step 72. For example, an assistant may actuatea clutch mode button on the manipulator, the tool may reach the end ofits useful life, a manipulator fault may be detected, or the like. Inother embodiments, the system operator may initiate method 70 byrequesting a new tool at a step 74, or in some other manner indicatingwhich of one or more manipulator assemblies is to generate a signal tobe perceived by an assistant or some other person.

Regardless of whether the signal is initiated by a change in state or asystem operator, the processor will typically transmit an appropriatecommand to one or more of the manipulator assemblies at a step 76, and,in response, the indicator on that manipulator assembly will display avisual signal at a step 78. Optionally, corresponding graphics may beshown in a system operator display at a step 80, thereby allowing thesystem operator to maintain his or her concentration on the internalsurgical site.

In response to the visual signal, the other person, such as anassistant, may optionally reconfigure the manipulator assembly at a step82. For example, the assistant may remove and replace a tool (with itsend effector) or may manually reposition the manipulator linkage so asto move the end effector into a desired position. In some embodiments,the assistant may merely monitor the manipulator assembly in response toone or more visual signals, and may optionally prepare to take someappropriate action if the visual signal changes so as to indicate thatsuch an action is appropriate.

Embodiments described above illustrate but do not limit the invention.It should also be understood that numerous modifications and variationsare possible in accordance with the principles of the present invention.For example, the number of LEDs may vary. Accordingly, the scope o theinvention is defined only by the following claims.

1-29. (canceled)
 30. A surgical manipulator assembly, comprising: amanipulator movably supporting a tool holder; and an indicator sectionoperably coupled to the manipulator for indicating state or identityinformation, the indicator section including a multiple-color lightemitting diode (LED) and a first fastener for operably coupling a secondfastener of a sterile drape used to substantially cover the surgicalmanipulator assembly.
 31. The assembly of claim 30, wherein themultiple-color LED is a tri-colored LED capable of displaying red,green, and blue.
 32. The assembly of claim 30, further comprising ahousing having a rough exterior surface and a smooth interior surface.33. The assembly of claim 32, wherein the housing is comprised of amaterial selected from the group consisting of polycarbonate and a clearplastic.
 34. The assembly of claim 30, wherein the state information isselected from the group consisting of a state of a tool mounted on thetool holder, and a state of the manipulator assembly.
 35. The assemblyof claim 30, wherein the identity information is selected from the groupconsisting of an identity of a mounted tool, and an identity of themanipulator assembly.
 36. The assembly of claim 30, further comprising atool mountable on the tool holder.
 37. The assembly of claim 36, whereinthe tool is selected from the group consisting of jaws, scissors,graspers, needle holders, micro-dissectors, staple appliers, tackers,suction irrigation tools, clip appliers, cutting blades, cautery probes,irrigators, catheters, and suction orifices.
 38. The assembly of claim32, further comprising a manipulator clutch switch threaded into thehousing.
 39. The assembly of claim 30, wherein the first fastenerincludes a magnet and the second fastener includes a metal tab.
 40. Theassembly of claim 30, wherein the first fastener includes a metal taband the second fastener includes a magnet.
 41. The assembly of claim 30,further comprising a grip point located on a surface of the indicatorsection selected from the group consisting of a front, back, and sidesurface.
 42. A surgical manipulator assembly, comprising: a manipulatormovably supporting a tool holder for mounting a tool; and an indicatorsection operably coupled adjacent to the tool holder of the manipulator,the indicator section configured to indicate state or identityinformation, the indicator section including a multiple-color lightemitting diode (LED) and a magnet for operably coupling to a metal tabof a sterile drape used to substantially cover the surgical manipulatorassembly.
 43. The assembly of claim 42, wherein the tool is selectedfrom the group consisting of jaws, scissors, graspers, needle holders,micro-dissectors, staple appliers, tackers, suction irrigation tools,clip appliers, cutting blades, cautery probes, irrigators, catheters,and suction orifices.
 44. The assembly of claim 42, wherein themultiple-color LED is a tri-colored LED capable of displaying red,green, and blue.
 45. The assembly of claim 42, further comprising ahousing having a rough exterior surface and a smooth interior surface.46. The assembly of claim 42, wherein the state information is selectedfrom the group consisting of a state of the tool mounted on the toolholder, and a state of the manipulator assembly.
 47. The assembly ofclaim 42, wherein the identity information is selected from the groupconsisting of an identity of the tool mounted on the tool holder, and anidentity of the manipulator assembly.
 48. The assembly of claim 42,further comprising a grip point located on a surface of the indicatorsection selected from the group consisting of a front, back, and sidesurface.
 49. A robotic surgical manipulator system, comprising: amanipulator assembly, including: a manipulator movably supporting a toolholder, and an indicator section operably coupled adjacent to the toolholder of the manipulator, the indicator section configured to indicatestate or identity information, and the indicator section including amultiple-color light emitting diode (LED) and a first fastener foroperably coupling to a second fastener of a sterile drape used tosubstantially cover the manipulator; a tool mounted on the tool holder;and a processor operably coupled to the manipulator assembly forinducing the LED to indicate state or identity information.